Headache Intensity Research Articles

Нумулярний головний біль (клінічне спостереження, обговорення)

The purpose of the study was to show the importance of using international diagnostic criteria of headache in neurological practice through description of clinical case of nummular headache. Materials and methods. Complaints, medical history, life history, results of objective and neurological examination, data of laboratory and instrumental research methods in a patient with nummular headache. Results and discussion. Patient G., 53 years old, complained of constant, dull, local, moderate pain in the right parietal area. The headache appeared gradually 5–6 months ago, without any evident triggers. Patient denied autonomic trigeminal signs, nausea, photo- and phonophobia. Painkillers intake was accompanied by a temporary slight decrease of headache intensity. At examination patient pointed to local pain area in the right parietal region that had diameter about 3 cm, rounded shape and clear borders. Neurological status – without abnormalities, except for hyperalgesia in the pain area. The skin and hair in the pain area were not changed, touching the skin in this place caused unpleasant feeling. General and biochemical blood tests, blood glucose, general urine analysis were within reference values; magnetic resonance imaging of the brain was without abnormalities; magnetic resonance imaging of the cervical spine showed osteochondrosis, protrusion of intervertebral discs C5-C6, C6-C7. Additional examination was recommended to the patient: computer tomography of the head (skull bones were unchanged), consultation of a dermatologist (no pathology was found). Finally, it was concluded that patient's condition, according to the international classification of headache disorders of the 3rd revision, corresponds to the diagnosis of “nummular headache”. Gabapentin was prescribed 300 mg per day, followed by increasing of the drug dose by 300 mg every 3 days to a daily dose of 1200 mg or until a significant reduction (disappearance) of headache occurred at the lower gabapentin doses. After 1 week of gabapentin taking, patient reported significant decrease in headache intensity at a daily dose of 600 mg with subsequent headache disappearance at a daily dose of 900 mg. It was recommended to continue gabapentin taking at a dose of 900 mg per day for the next 3 months. After 3 months, the patient reported no headache during the entire period of gabapentin usage. It was recommended to reduce the daily dose of gabapentin by 300 mg every 5 days until the headache recurs or until total discontinuation of drug intake. 1 month later the patient reported no headache since stopping gabapentin intake. Conclusion. Neurologists need to know and actively use in their practice the international diagnostic criteria of nummular headache, that is the basis of adequate management of this rare primary headache

Acupuncture for migraine prophylaxis: A protocol for systematic review and Bayesian network meta-analysis

Migraine causes health problems in 1 billion people worldwide and imposes a huge social burden. Acupuncture therapy has a good clinical effect in migraine prophylaxis and is recommended by authoritative journals. We plan to conduct a Bayesian network meta-analysis to compare the efficacies of different acupuncture therapies. We will search PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP database for Chinese technical periodicals, Chinese biological medical database, WanFang Data, Cochrane register of controlled trials, Chinese Clinical Trial Register, and ClinicalTrials.gov from their inception to July 1, 2022, for randomized controlled trials that studied different acupuncture therapies and other therapies for the preventive treatment of migraine. Migraine episodes, migraine days, headache intensity, and adverse events will be counted as outcomes. Two reviewers will independently complete the study selection, data extraction, and risk of bias assessment of all filtered trials. Pairwise meta-analysis and Bayesian network meta-analysis will be performed (if applicable) through Review Manager 5.3 and the "gemtc" and "rjags" packages of the R software. Confidence in Network Meta-Analysis will be used to evaluate the quality and credibility of the evidence for each outcome. The protocol will compare the efficacies of different acupuncture therapies for migraine prophylaxis. This study aims to help clinicians develop an effective and safe treatment plan for migraine prophylaxis.

The effect of an epigenetic diet on migraine patients

Migraine is a common type of primary headache disorder, distinguished by recurrent attacks of moderate to severe unilateral throbbing pain, often accompanied by symptoms such as nausea, photophobia, and phonophobia.
 Objective — to study the effect of epigenetic diet on frequency and intensity of migraine headache attacks, indicators of psycho‑emotional status and quality of life of migraine patients.
 Methods and subjects. 130 people aged from 18 to 55 years (average age — 38.6 ± 8.3 years) were examined, of which 15 (11.5 %) were men and 115 (88.4 %) were women. The patients were distributed into two groups: group A — patients who followed an epigenetic diet enriched with 5 mg of folic acid, group B — patients who did not follow any diet. The diagnosis of migraine was confirmed using the criteria of the International Headache Society. Before the study, all participants were assessed using the Work Disability Assessment Scale (MIDAS). Also, the frequency of headache was determined in all patients. Headache intensity was assessed using a visual analog scale (VAS). Psychoemotional status at the beginning and at the end of the study was assessed using the Hamilton Anxiety Scale and the Beck Depression Scale. In all patients, the content of folic acid and homocysteine in the blood was determined using an immunochemical method with electrochemiluminescence detection.
 Results. When analyzing the data before the start of the study, it was found that the average concentration of folic acid in group A was 2.8 ± 3.6 ng/ml and was significantly lower than in group B (p = 0.003). The average level of homocysteine was different in both groups (р = 0.04). In group A, against the background of using an epigenetic diet, the average level of folic acid remarkably increased (p = 0.001), and the average level of homocysteine significantly decreased (p = 0.003). Also, in group A, a notable decrease in the intensity and frequency of headache was found (р = 0.02; р = 0.04), a decrease in the average level of anxiety according to the Hamilton scale (from 15.0 ± 3.5 points to 9 ± 2 points) (p = 0.03). A direct relationship between the level of homocysteine and the score on the Hamilton Anxiety Scale and the MIDAS scale was established, as well as a negative correlation between the level of folic acid and the score on the Beck Depression Scale.
 Conclusions. Evidence of the influence of changes in the content of homocysteine and folic acid in the blood of patients with migraine against the background of an epigenetic diet on the severity of headache and quality of life was revealed. The use of an epigenetic diet in the prevention and treatment of migraine needs further study, as it is difficult to predict the final effect of the diet due to its low specificity to the epigenome and the large number of interactions between the active components of the diet.

Intermediate Cervical Plexus Block (ICPB) In Refractory Chronic Daily Headache After Whiplash: Prospective Audit In 43 Patients

Background: Chronic daily headache can develop or pre-existing episodic headache can worsen after whiplash and is termed persistent headache attributed to whiplash. It can be a therapeutic challenge and often results in severe disability. The objective was to assess the management of patients with refractory secondary chronic daily headache referred to a pain physician in consideration for greater occipital nerve block. Methods: Prospective service evaluation in adult patients with oro-facial pain and headaches. Patients underwent specialist neurology review and analgesic overuse headache was excluded. Patients with chronic daily headache with a past history of neck trauma were included. Cervical facet joint dysfunction and intracranial pathology were excluded. An initial cohort of 27 patients received occipital nerve block without benefit. Subsequently, all patients were offered ultrasound guided intermediate cervical plexus block with local anesthetic and steroid mixture. Four-week headache diary, Brief Pain Inventory-Short Form and Hospital Anxiety Depression Scale questionnaires were completed at baseline and three months post-intervention. Results: Over a 41-month period, 43 patients were reviewed. The first 27 patients (27/43, 63%) reported no benefit with occipital nerve block. Subsequently, patients were offered intermediate cervical plexus block(s). Four patients refused. Thirty-nine patients received the intervention. Thirty-two patients (32/39, 82%) reported significant reduction in headache frequency and intensity at three months. Failure rate was 18% (7/39). Conclusion: The cervical plexus could play a significant role in the development or worsening of pre-existing headache after whiplash. Intermediate cervical plexus block may have a role in the management of refractory chronic daily headache following whiplash injury.

Impact of comorbid psychogenic non-epileptic seizures on migraine: An observational study.

There is a bidirectional and complex interplay between psychiatric comorbidities and migraine. Migraine has been observed in 50-60% of patients with psychogenic non-epileptic seizures (PNES). Studies describe migraine as a medical comorbidity in PNES. However, there are limited studies on impact of PNES on migraine. We aim to see the impact of PNES on migraine. This cross-sectional and observational study was conducted at a tertiary-care center from June 2017 to May 2019. Fifty-two patients with migraine with PNES and 48 patients with migraine without PNES were included on the study. Migraine and PNES were diagnosed based on International Classification of Headache Disorders-3 (ICHD-3) and International League Against Epilepsy (ILAE) criteria, respectively. Headache intensity was assessed using visual analog scale. Comorbid depression, anxiety, and somatoform-symptom-disease were assessed using the Generalized Anxiety Disorder-7 Scale, Patient Health Questionnaire-9, and DSM-5 criteria, respectively. Females were common in both groups and the difference was statistically insignificant. Headache frequency was significantly more in patients with migraine with PNES (P < 0.05). However, headache intensity was similar in both groups. Patients with headaches and PNES identified triggers less commonly except for stress. Depression and somatoform symptom disorder were significantly more common in patients with migraine with PNES. Abnormal neurocircuitry involving frontal, limbic, and thalamic regions due to comorbid PNES may cause central sensitization, resulting in frequent migraine headaches which is further augmented by coexisting depression and somatoform-symptom-disease. Migraine with PNES patients suffers more frequent headaches than patients with migraine without PNES. They differ in various headache triggers, with mental stress being the predominant trigger.

Study on key outcome indexes in treatment of migraine with acupuncture and moxibustion

To identify the key outcome indexes in treatment of migraine with acupuncture and moxibustion. Using literature research, questionnaire survey and consensus conference, the key outcome indexes in treatment of migraine with acupuncture and moxibustion were screened and prioritized. The critical outcome indexes for the treatment in attack stage of migraine included 6 effectiveness outcome indexes (headache intensity, headache duration, headache relieve time, effectiveness and level of headache relief within 2 h, headache-related quality of life, level of headache relief within 24 h) and 1 safety outcome index (incidence of serious adverse reactions). The critical outcome indexes for prophylactic treatment included 6 effectiveness outcome indexes (headache day, headache frequency, headache intensity, effective rate, headache-related quality of life, health-related quality of life) and 1 safety outcome index (incidence of serious adverse reactions). In terms of the attack stage treatment and prophylactic treatment with acupuncture and moxibustion, the outcome indexes are different, among which, those can directly reflect the conditions of migraine should be optioned in priority. To assess the effectiveness of attack stage, the headache intensity is preferred, using the visual analogue scale (VAS) score, and the preferred time is 2 hours after treatment. Regarding the effectiveness of prophylactic treatment, the headache day, headache frequency and headache intensity should be firstly considered in the assessment, in which, the preferred time for assessment is 12 weeks into treatment, while, the best time for follow-up should be 12 weeks after treatment completion. When the quality of life is considered, the migraine-specific quality of life questionnaire (MSQ) is the top option. For either the attack stage treatment or the prophylactic treatment, the high attention should be laid on the outcome indexes for safety and medical economics evaluation.

Does the Intensity of the Headache Differ According to the Level of Neck Disability in Chronic Migraine Patients?

Chronic migraine (CM) patients who report a high frequency and intensity of headaches also report neck pain (NP) and neck disability (ND) in neck activities that require stability. In this context, CM patients may report different headache intensities at different levels of ND. Our aim in this study is to investigate whether the intensity of headaches differs according to the level of ND in CM patients. Headache intensity and NP intensity were evaluated with the Visual Analog Scale (VAS), and ND was evaluated with the Neck Disability Index (NDI). A total of 142 patients who met the inclusion criteria were included in the study. The mean age was 53.24 ± 12.08 years. The median number of monthly headache days was 20. According to VAS, the median headache intensity was 10(4-10) cm and the median of NP intensity was 9(1-10) cm. The mean NDI was 28.45 ± 10.28. There was a difference in headache intensity between mild and severe disability levels (p = 0.007, Z = -3.289); headache intensity between mild and complete disability levels (p = 0.000, Z = -4.421); and headache intensity between moderate and complete disability levels (p = 0.004, Z = -2.212). Although the difference in headache intensity between ND levels is small, a median increase of 2 cm in headache intensity at mild ND levels may result in complete ND. A median increase of 1 cm in headache intensity at the moderate ND level may cause complete disability in the neck. According to our results, the intensity of headaches of CM patients differed according to the level of ND. We consider our results to be clinically important in this context.

The potential impact of migraine headache on retinal nerve fiber layer thickness

BackgroundMigraine is a common, chronic, multifactorial neurovascular disorder. It may result in hypoperfusion of other areas other than the brain, as the eye. It may lead to change of the retinal nerve fiber layers (RNFL) thickness and axonal loss even up to severe damage of the eye structures, including the retina with frequent headache attacks. This study aimed to quantify the thickness of RNFL which gives a good idea about the condition of axons and loss of ganglion cells in migraine patients. Also, to detect if there is any correlation between these measurements and clinical characteristics of migraine.ResultsThe RNFL thickness was significantly thinner in patients with migraine compared to healthy controls in all quadrants of retina in both sides (p value < 0.05). However, there was no significant difference in RNFL thickness in migraine patients with aura compared to patients without aura in all retinal quadrants in both sides (p value > 0.05). The headache intensity was negatively correlated with RNFL thickness in the inferior (r = − 0.342, P = 0.031) and nasal (r = − 0.349, P = 0.027) quadrants on LT side, also there was a significant positive correlation between RNFL thickness and both of nausea and tolerability in the RT superior quadrant (r = 0.467, P = 0.002); (r = 0.322, P = 0.043), respectively, but there was no significant correlation found between the RNFL thickness and disability, attacks duration, disease duration and frequency in all retinal quadrants on both sides (P > 0.05).ConclusionThe main conclusion of our work was that RNFL thickness was significantly affected in migraine patients in comparison to healthy controls, but there were no significant impact of the migraine characteristics including aura, severity, frequency, or duration of headache attacks on RNFL thickness.

OnabotulinumtoxinA Add-On to Monoclonal Anti-CGRP Antibodies in Treatment-Refractory Chronic Migraine.

We sought to assess the effectiveness of combining dual therapy with onabotulinumtoxinA (BTX) add-on to anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (anti-CGRP MAbs) in treatment-refractory patients with chronic migraine (CM). We retrospectively reviewed the medical files of 19 treatment-refractory patients with CM who had failed to two oral migraine preventatives, at least three consecutive BTX cycles (less than 30% response rate), at least three consecutive sessions with either fremanezumab or erenumab (less than 30% response rate), and were eventually switched to dual therapy with BTX add-on to any of the already-given anti-CGRP MAbs. We then assessed from baseline to each monotherapy or dual intervention predefined efficacy follow-up the changes in the following efficacy outcomes: (i) monthly headache days (MHD), (ii) monthly days with moderate/severe peak headache intensity, and (iii) monthly days with intake of any acute headache medication. Response (50% reduction in MHD) rates, safety, and tolerability were also determined. In the majority of cases (n = 14), dual targeting proved effective and was associated with clinically meaningful improvement in all efficacy variables; 50% response rates (also disability and QOL outcomes) coupled with favorable safety/tolerability. Our results advocate in favor of the view that dual therapy is effective and should be considered in difficult-to-treat CM patients who have failed all available monotherapies.

Hubungan Intensitas Nyeri Kepala Tipe Tegang Dengan Derajat Depresi

Depression is a natural feeling disorder (mood) which is characterized by excessive feelings of sadness, depression, lack of enthusiasm, feeling worthless, feeling that life is empty and hopeless, thinking is centered on failure and self-blame or self-blame, and often accompanied by envy and suicidal thoughts. Depressive disorders can occur in anyone with a higher risk of physical illness, which is about 15-60%. Medical conditions that have long been associated with depressive disorders include primary tension-type headache (TTH). Patients with chronic TTH will experience more severe depression than episodic TTH and chronic headache is significantly associated with psychopathological scores, but the direction of the relationship is not clear. This study aims to determine the relationship between the intensity of tension-type headaches and the degree of depression. This research is an observational analytic study with a cross sectional research design. To find out the frequency and duration of tension-type headaches, the history and filling of the questionnaire provided were carried out. Then the Beck Depression Inventory (BDI) questionnaire was used to assess the degree of depression. Patients with tension headaches were assessed based on The International Headache Classification 2nd Edition in 2004, and pain intensity was assessed based on the NPRS (Numeric Pain Rating Scale) score. The results showed that the Spearman correlation test obtained a significance value of 0.014, a correlation value of 0.399. between the Numeric Pain Rating Scale (NPRS) and Visual Analog Scale (VAS) scores with the Beck Depression Inventory (BDI) score on the subject of tension-type headache, and there is a significant relationship between the intensity of the tension-type headache and depression where the higher the pain intensity, the more severe the pain. degree of depression.

Acupuncture for menstrual migraine: a systematic review

Background and objectiveIn clinical practice, the evidence of acupuncture used as a treatment for migraine without aura is employed interchangeably to guide treatment for menstrual migraine. However, its effect and...

Anterior cervical decompression and fusion surgery for cervicogenic headache: A multicenter prospective cohort study.

Cervicogenic headache (CEH) has long been recognized as a referred pain deriving from pathological changes in the upper cervical nerves. However, previous clinical studies found that anterior lower cervical discectomy for the treatment of cervical myelopathy and/or radiculopathy can also help relieve associated headaches. To date, there is still a lack of large sample and prospective study to investigate the effect of anterior cervical decompression and fusion (ACDF) on CEH associated with cervical spondylosis. A total of 656 patients with cervical radiculopathy and/or myelopathy were enrolled in three spinal centers. Among them, 221 patients who were diagnosed with CEH were collected in this study, and 204 completed a 1-year follow-up. The primary endpoint was headache intensity during a 12-month follow-up period measured by the numeric pain rating scale (NPRS). The secondary outcome measures included headache frequency, headache duration, and the neck disability index (NDI). Among all 204 patients with CEH who completed a 1-year follow-up, 166 received anterior cervical surgery (surgery group) and 38 received conservative treatment (conservative group). There were statistically significant lower NPRS in the surgical group during follow-up. Between-group differences showed that NPRS in the surgery group was significantly greater improvement at 1 month (2.8, 95% CI: 2.0, 3.6), 3 months (2.6, 95% CI: 1.8, 3.4), 6 months (2.4, 95% CI: 1.6, 3.2), and 12 months (1.5, 95% CI: 0.7, 2.4) (p < 0.05 for all). There were statistically significant lower NDI, less frequent headaches, and lower headache duration in the surgery group during follow-up (p < 0.05 for all). This study indicates that ACDF can effectively relieve CEH associated with cervical myelopathy and/or radiculopathy.

Prediction and associated factors of non-steroidal anti-inflammatory drugs efficacy in migraine treatment.

Background: The selection strategy of non-steroidal anti-inflammatory drugs (NSAIDs) for migraine is hard to judge whether it is effective, leading to unnecessary exposure to insufficient or lengthy treatment trials. The goal of the study was to investigate potential predictors of NSAIDs efficacy in migraine therapy and to explore their influence on efficacy. Methods: 610 migraine patients were recruited and assigned into responders and non-responders. Potential predictors among demographic and clinical characteristics for NSAIDs efficacy were extracted using multivariable logistic regression (LR) analysis, and were applied to construct prediction models via machine learning (ML) algorithms. Finally, Cochran-Mantel-Haenszel tests were used to examine the impact of each predictor on drug efficacy. Results: Multivariate LR analysis revealed migraine-related (disease duration, headache intensity and frequency) and psychiatric (anxiety, depression and sleep disorder) characteristics were predictive of NSAIDs efficacy. The accuracies of ML models using support vector machine, decision tree and multilayer perceptron were 0.712, 0.741, and 0.715, respectively. Cochran-Mantel-Haenszel test showed that, for variables with homogeneity of odds ratio, disease duration, frequency, anxiety, and depression and sleep disorder were associated with decreased likelihood of response to all NSAIDs. However, the variabilities in the efficacy of acetaminophen and celecoxib between patients with mild and severe headache intensity were not confirmed. Conclusion: Migraine-related and psychiatric parameters play a critical role in predicting the outcomes of acute migraine treatment. These models based on predictors could optimize drug selection and improve benefits from the start of treatment.

Comparative Short-Term and Long-Term Effects of Neck Massage and Self-Massage on Tension Type Headache

Background. Tension-type headache is a common complaint in modern society. Self-massage or massage can be prescribed to reduce it, but it is still unclear which of these techniques is more effective in reducing tension-type headaches. The aim of the study is to determine the short-term and long-term effects of neck massage and self-massage in tension-type headache. Methods. 30 people participated in the study, who were randomly divided into two groups: massage and self-massage, 15 people in each group. Outcome measures were subjects’ headache intensity, active head range of motion, fatigue, and functional and emotional disability index pre and post the nine-week interventions and long-term effect – one month after the interventions. Results. Both massage and self-massage after the 9-week interventions significantly reduced pain-related indicators. One month after the interventions, the headache intensity, fatigue, functional and emotional disability of subjects in the self-massage group were significantly (p &lt; 0.05) lower, and the active amplitudes of neck movements were significantly higher (p &lt; 0.05) than in the massage group. Conclusions. Both massage and self-massage significantly reduced subjects’ headaches, increased head range of motion, reduced fatigue, and functional and emotional disability. However, one month after the interventions, the long-lasting effect of self-massage was significantly superior to the massage group. Keywords: pain, functional disability, emotional disability, fatigue.

The Addition of Diacutaneous Fibrolysis to a Pharmacological Intervention in Patients with Tension-Type Headache: A Randomized Controlled Trial.

Tension-type headache (TTH) is the most common headache worldwide. Pharmacological interventions are the most investigated therapies in patients with TTH. The addition of physical therapy treatments such as diacutaneous fibrolysis (DF) may have promising results. The aim of this study was to investigate the addition of three sessions of DF to a pharmacological intervention in patients with TTH. A single-blinded randomized controlled trial was carried out. Participants were randomly assigned to the standard care group or to the DF group. Both groups received a pharmacological intervention. Three sessions of DF in the thoracic and cervicocranial region were added in the DF group. The impact caused by headache (HIT-6), headache intensity, and cervical range of motion were measured by blinded assessors at baseline, after the intervention, and at 1 month follow-up. Eighty-two patients with TTH were included (41 standard care group; 41 DF group). Statistically significant differences were found between both groups in all the variables after the intervention and at 1 month follow-up (p &lt; 0.001). No adverse effects or side-effects were reported during the study. The addition of three sessions of DF to a pharmacological therapy provided improvements in the impact caused by headache, headache intensity, and cervical range of motion after the intervention and at 1 month follow-up compared to a pharmacological therapy in isolation. Further research is needed to investigate long-term effects.

Effects on neuromodulation, acupuncture, and aerobic exercises on migraine and tension-type headache outcomes: A systematic review and meta-analysis.

Headache disorders are common diseases that cause a social burden. This systematic review and meta-analysis aimed to evaluate the effects of various non-pharmacological treatments to address or prevent acute headaches, including neuromodulation, acupuncture, and aerobic exercises in patients with episodic migraine and tension-type headache (TTH). We performed a systematic search of the electronic databases PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WANFANG MEDICINE ONLINE, and Chinese Medical Journal database using Stata/SE 14.0 to obtain weighted mean differences (WMDs). The outcomes included monthly headache days, headache intensity, headache duration, days per month of acute medication use, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Of 872 identified articles, 27 were included in the meta-analysis. Neuromodulation was associated with reduced headache days (WMD: -1.274, 95% CI [-1.914, -0.634], P < .001), duration (WMD: -2.2, 95% CI [-3.32, -0.107], P < .001) and medication consumption (WMD: -1.808, 95% CI [-2.546, -1.071], P < .001) in cases of migraine. Acupuncture was associated with the alleviation of headache days (WMD: -0.677, 95% CI [-0.932, -0.422], P < .001) and intensity (WMD: -0.893, 95% CI [-1.573, -0.212], P = .01) in cases of migraine and acute medication use (WMD: -3.29, 95% CI [-4.86, -1.72], P < .001) in cases of TTH. Aerobic exercise was associated with reduced headache duration (WMD: -5.1, 95% CI [-8.97, -1.22], P = .01) in cases of TTH. The risk of bias for included articles was moderate. There is low- and moderate-quality evidence that neuromodulation, acupuncture, and aerobic exercises are associated with attenuated headache symptoms in patients with episodic migraine or TTH. However, high-quality studies are needed to draw more detailed conclusions.

Effects of regular yoga practice on neurological conditions and mental health

Introduction Nowadays it is pointed out how important it is to take care of both mental and physical health. It is also undeniable that one affects the other and vice versa. That is why it is so important to nurture your body. Yoga as one of the physical activities has a proven effect on psychosomatic symptoms. Yoga is increasingly recommended mainly to relieve anxiety or stress. It brings great solace and even greater attentiveness. Lifestyle activities are increasingly considered an important component of treatment. State of knowledge Medical conditions such as dementia, Parkinson's disease, headaches, PTSD, depression are mainly treated with drugs. Yoga, as a non-pharmacological treatment, alleviates psychological conditions, as it reduces stress, anxiety, depressive symptoms, and enhances attentiveness to one's self, self-control and a different perspective on traumatic situations. Conclusions A review of the following works has shown the effects of yoga on mental health and common neurological conditions. With regular practice, it is possible to develop cognitive function, reduce the intensity and frequency of headaches. In Parkinson's disease, mindfulness exercises lead to an increase in muscle strength, a decrease in muscle tremors, and therefore improved rehabilitation. Most of the examples below mention a decrease in anxiety, stress, depressive symptoms and an increase in mindfulness, greater emotional and physical flexibility. The works cited point out that more in-depth research is needed to delve deeper into the effects of yoga on health.

Face mask and protective eyewear-associated headache among healthcare workers during the COVID-19 pandemic.

The objective of this study was to investigate the prevalence, clinical features, and factors related to personal protective-associated headaches. We conducted a cross-sectional study among healthcare workers using an online questionnaire. We surveyed 305 participants. The N95 face-mask was the most used device by 93%. Of 305 respondents, 206 experienced headaches while wearing protective equipment; 36.06% suffered from a headache disorder before the pandemic. The prevalence of de novo headache was 39.01%. Gender, age, or exposure to coronavirus disease were not determining factors to develop headache. Headache intensity was higher in front-line healthcare workers and was correlated (r = 0.728) with the time wearing protective equipment. The more days per month the participants wore personal protective equipment the shorter the time to headache onset after donning equipment. Our study confirms the relationship between frequent and prolonged use of protection devices with headaches and reaffirms the implication of external pressure as a primary mechanism.

A Study on Prevalence of Trigger Factors and Associated Disorders in Tension-type Headache.

To study the prevalence of trigger factors and associated disorders in tension-type headache (TTH). Trigger factors have been widely studied in the context of migraine, but very few studies have investigated trigger factors in the context of TTH. A total of 400 patients above the age of 15 years fulfilling the third edition of the International Classification of Headache Disorders (ICHD 3) criteria of frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) were enrolled and evaluated using a questionnaire. Details regarding demographics, headache characteristics, triggers, and associated symptoms were obtained. Associated psychiatric disorders were also recorded. Data were analyzed using Microsoft Excel and statistical analysis was done using SPSS 22 trial version. Chi-square test and Fischer's exact test were used for statistical analysis and subgroup comparison. Out of 400 patients, 360 (90%) were found to have triggers. The mean headache intensity on visual analog scale (VAS) was 6.7. The most common trigger factor was emotional stress among both males and females. There was a statistically significant difference in the frequency of trigger factors between men and women for emotional stress, sunlight, sleep deprivation/insomnia, noise, weather change, studying, fried food, and hypersomnia. Psychiatric comorbidity was found in 29% of individuals, with sleep disorder being the most common. TTH has been an underrated diagnosis despite being an extremely common disorder. The trigger factors are less studied and their interactions are lesser known. The diagnostic criteria as per ICHD 3 make TTH a diagnosis of exclusion, rather than a positive diagnosis of inclusion. The trigger factors must be included in the diagnostic criteria in future versions of ICHD and associated psychiatric disorders should be sought for and treated simultaneously for better management and quality of life.

Modulation of Central Nociceptive Transmission by Manual Pressure Techniques in Patients with Migraine: An Observational Study.

Manual pressure in the upper cervical spine is used to provoke and reduce the familiar migraine headache. Information is scarce on the segmental levels, myofascial structure provocation, and reduction occurrences. The required dosage (amount of pressure, number of repetitions, and duration) has not been objectified yet. Prospective observational study. Thirty patients with migraine were examined interictally. Manual pressure was applied at four sites: the posterior arch of C1, the articular pillar of C2, the rectus capitis posterior major muscle, and the obliquus capitis inferior muscle, bilaterally. On sites where the familiar headache was provoked, the pressure was sustained to induce pain reduction (three repetitions). Provocation of familiar headache (yes/no), headache intensity (numerical pain rating scale), time to obtain a reduction of the headache (seconds), and applied pressure (g/cm2) were recorded. Provocation of the familiar headache occurred at the posterior arches C1 in 92%, and at one of the articular pillars of C2 in 65.3% of cases. At one of the rectus capitis major muscles, the familiar headache was provoked in 84.6% of cases; at one of the oblique capitis inferior muscles, the familiar headache was provoked in 76.9% of cases. The applied mean pressure ranged from 0.82 to 1.2 kg/cm2. Maintaining the pressure reduced headache pain intensity significantly between the start and end of each of the three consecutive trials (p &lt; 0.04). This reduction occurred faster in the third application than in the first application (p = 0.03). Manual pressure at upper cervical segments provokes familiar referred migraine headaches, with low manual pressure. Maintaining the pressure reduces the referred head pain significantly, indicating modulation of central nociceptive transmission.